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Open Access 01-03-2020 | Acute Lymphoblastic Leukemia

Insights into the prenatal origin of childhood acute lymphoblastic leukemia

Authors: Daniel Hein, Arndt Borkhardt, Ute Fischer

Published in: Cancer and Metastasis Reviews | Issue 1/2020

Abstract

Pediatric acute lymphoblastic leukemia (ALL) is defined by recurrent chromosomal aberrations including hyperdiploidy and chromosomal translocations. Many of these aberrations originate in utero and the cells transform in early childhood through acquired secondary mutations. In this review, we will discuss the most common prenatal lesions that can lead to childhood ALL, with a special emphasis on the most common translocation in childhood ALL, t(12;21), which results in the ETV6-RUNX1 gene fusion. The ETV6-RUNX1 fusion arises prenatally and at a 500-fold higher frequency than the corresponding ALL. Even though the findings regarding the frequency of ETV6-RUNX1 were originally challenged, newer studies have confirmed the higher frequency. The prenatal origin has also been proven for other gene fusions, including KMT2A, the translocations t(1;19) and t(9;22) leading to TCF3-PBX1 and BCR-ABL1, respectively, as well as high hyperdiploidy. For most of these aberrations, there is evidence for more frequent occurrence than the corresponding leukemia incidences. We will briefly discuss what is known about the cells of origin, the mechanisms of leukemic transformation through lack of immunosurveillance, and why only a part of the carriers develops ALL.

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Title: Insights into the prenatal origin of childhood acute lymphoblastic leukemia
Authors: Daniel Hein
Arndt Borkhardt
Ute Fischer
Publication date: 01-03-2020
Publisher: Springer US
Keywords: Acute Lymphoblastic Leukemia
Leukemia
Published in: Cancer and Metastasis Reviews / Issue 1/2020
Print ISSN: 0167-7659
Electronic ISSN: 1573-7233
DOI: https://doi.org/10.1007/s10555-019-09841-1

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